Midterm Practice 2011

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Exam
Name___________________________________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
1)
The nurse is using a specific process to plan smoking cessation activities for a client. Which of the following is this nurse
most likely using to plan the care for this client?
1)
_______
A)
Critical pathways
B)
Nursing process
C)
Evidence-based practice
D)
Variance analysis
2)
The new nurse is studying the five core competencies for healthcare providers. Which of the following are a part of these core
competencies? (Select all that apply.)
2)
_______
A)
Use primary nursing to deliver care.
B)
Work in interdisciplinary teams.
C)
Replace quality improvement initiatives with work redesign methods.
D)
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Use informatics to deliver care.
E)
Use evidence-based practice.
3)
The client complaining of pain has been waiting for medication to relieve the pain. Which of the following should the nurse
realize about this client?
3)
_______
A)
The client wants attention.
B)
The client's pain is real.
C)
The client is demanding.
D)
The client just wants medication.
4)
A client wants to know why he developed an infection after being cut on the leg with a piece of wood, but his friend who was
also cut did not. Which of the following can the nurse explain to this client?
4)
_______
A)
"You must have an autoimmune disorder."
B)
"The organism found you more susceptible to the creation of an infection."
C)
"Maybe the wood that cut the friend wasn't dirty and infected."
D)
"Your friend will get an infection too. It will just occur later."
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5)
The nurse is instructing a client with type 1 diabetes about care during sick days. Which of the following should be included
in these instructions?
5)
_______
A)
Monitor blood glucose level every eight hours.
B)
Administer one-half of the prescribed insulin dose.
C)
Administer insulin dose as prescribed.
D)
Limit rest to only eight hours per day.
6)
The nurse is able to percuss a dull tone over a client's bladder. This finding is suggestive of:
6)
_______
A)
Normal.
B)
Colon cancer.
C)
Urinary retention.
D)
Pregnancy.
7)
The nurse should prepare the client for standard x-rays of an arm by:
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7)
_______
A)
Finding out the client's allergies.
B)
Initiating a peripheral IV in the opposite arm.
C)
Cleansing the arm with antibacterial cleanser.
D)
Doing no special preparation.
8)
A new nurse tells her mentor "you always seem so poised when you interact with the client. It is as if you always know what
to do. Can you teach me how to do that?" What characteristic does this mentor possess in relation to critical thinking?
8)
_______
A)
Discipline
B)
Self-confidence
C)
Independent thinking
D)
Empathy
9)
The nurse stops to think about a previous client care situation before providing care to a current client. This nurse is using
what critical thinking skill?
9)
_______
A)
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Reasoning
B)
Clarifying
C)
Reflection
D)
Divergent thinking
10)
The nurse working on a quality improvement study wants to evaluate a client care process. Which of the following can the
nurse use to evaluate this process?
10)
______
A)
Critical pathway
B)
Evidence-based practice
C)
Nursing process
D)
Variance analysis
11)
The nurse is reviewing the outcome of client care that was provided. Which of the following nursing process steps should the
nurse use next?
11)
______
A)
Assessment
B)
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Evaluation
C)
Planning
D)
Implementation
12)
A client tells the nurse, "I have pain in my leg when I stand too long." This information would be considered:
12)
______
A)
Evaluative data
B)
Objective data
C)
Subjective data
D)
Qualitative data
13)
While providing care to a client, the nurse stops to assess a new client problem. The assessment in this situation would be:
13)
______
A)
A focused assessment
B)
A subjective assessment
C)
An initial assessment
D)
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An objective assessment
14)
The nurse is implementing a plan of care for a client. After providing care, what should the nurse do as the final step in the
process?
14)
______
A)
Give the charge nurse a report.
B)
Nothing
C)
Document
D)
Reassess the client.
15)
A nurse has delegated the collection of vital signs, including blood pressure readings, to two unlicensed assistive personnel.
The of this work means the nurse is:
15)
______
A)
Responsible to re-measure all of the vital signs.
B)
Not accountable for these vital signs.
C)
Not responsible for these vital signs.
D)
Accountable for the care that was delegated.
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16)
A client asks the nurse, "What's the difference between having good health and being well?" Which of the following could the
nurse say in response?
16)
______
A)
"Wellness is a passive state of freedom from illness."
B)
"Good health maximizes individual potential."
C)
"There isn't a difference."
D)
"Wellness maximizes individual potential."
17)
A client tells the nurse, "Everyone in my family holds extra weight around their hips and legs." The nurse realizes this client is
describing which of the following health risk factors?
17)
______
A)
Developmental level
B)
Cultural background
C)
Cognitive ability
D)
Genetic makeup
18)
An African-American client comes into the clinic for a routine check-up. The nurse realizes this client is most prone to
developing which of the following health conditions?
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18)
______
A)
Diabetes mellitus
B)
Tuberculosis
C)
Hypertension
D)
Glaucoma
19)
The nurse is caring for a male client with heart disease. Which of the following would be considered the health promotion
behavior with the greatest impact for this client?
19)
______
A)
Cease smoking.
B)
Perform foot self-examinations daily.
C)
Perform breast self—examinations.
D)
Have a tetanus booster every ten years.
20)
A middle-aged adult is asking questions about avoiding the onset of heart disease. Which of the following would be an
appropriate intervention for this client?
20)
______
A)
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Sign them up to learn CPR.
B)
Ask the client the reasons for concern.
C)
Suggest that the client attend a one-day seminar about ways to prevent or reduce heart disease.
D)
Tell the client that heart disease is not a concern at their age.
21)
An old-old client tells the nurse, "I hate all of those throw rugs my daughter has on the floor." Which of the following is the
most significant risk factor for this client?
21)
______
A)
Falls
B)
Urinary tract infection
C)
Pneumonia
D)
Obesity
22)
A middle-old client is not recovering as anticipated from an acute respiratory infection. Which statement by the nurse can
provide the most useful assessment information?
22)
______
A)
"Are you sleeping at least seven hours per night?"
B)
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"Have you been able to purchase the antibiotics the doctor prescribed?"
C)
"Are you eating at least five servings of fruits and vegetables per day?"
D)
"Are you drinking enough fluids?"
23)
The nurse is assessing a client's vital signs. Which of the following should be assessed during this time?
23)
______
A)
Pain
B)
Urine output
C)
Ability to ambulate
D)
Peripheral pulses
24)
A client with a history of chronic pain tells the nurse, "I do a variety of things to make my body produce its own pain
reliever." The nurse realizes that this client is describing:
24)
______
A)
A belief in alternative methods
B)
One reason to reduce the amount of pain medication prescribed.
C)
A theory of denial.
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D)
The body's ability to make endorphins.
25)
A client with chronic pain tells the nurse that he "rarely sleeps more than 3 hours a night." The nurse realizes that this client is
at risk for developing:
25)
______
A)
Adult attention deficit disorder.
B)
Chronic insomnia.
C)
Depression.
D)
High pain tolerance.
26)
A client with chronic pain is desperately searching for something to relieve the pain. Which of the following would be helpful
for this client to consider?
26)
______
A)
Evaluation by a psychiatrist to determine if the client is really depressed
B)
Develop a pain medication schedule to help avoid the onset of pain.
C)
Avoid the use of narcotics.
D)
A thorough analysis of the pain to determine if it is truly pain
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27)
A client has periodic severe nerve pain that is not being well-controlled with pain medication. The nurse thinks that this client
might benefit from:
27)
______
A)
A local anesthetic.
B)
A narcotic.
C)
An antidepressant.
D)
A nonsteroidal anti-inflammatory drug (NSAID).
28)
A client who is receiving pain medication around the clock complains of an acute exacerbation of pain. What should the nurse
do to help this client?
28)
______
A)
Provide the medication ordered for breakthrough pain.
B)
Talk the client through the pain.
C)
Give the client a nonsteroidal anti-inflammatory drug (NSAID).
D)
Encourage the client to ignore the pain.
29)
A client with chronic pain is being started on a "patch". Which of the following should be included when instructing the client
about this pain-relieving delivery system?
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29)
______
A)
The client will never overdose with this delivery method.
B)
Dosing will start with a lower dose.
C)
It will not work as well as oral pain medications.
D)
The client will never experience breakthrough pain.
30)
The nurse is assessing a client's pain perception. Which of the following methods of assessment would be useful for this?
30)
______
A)
Biofeedback rating
B)
FACES scale
C)
PQRST guide
D)
Psychological evaluation tool
31)
A client is seen talking and laughing in the clinic's waiting room yet complains of excruciating pain. The nurse realizes this
client is most likely demonstrating:
31)
______
A)
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Denial.
B)
The desire for narcotics.
C)
Fake pain.
D)
Inconsistent behavioral response to pain.
32)
The nurse assesses a client's skin color as "pasty white". When documenting findings, the nurse should use which of the
following to describe this client's skin color?
32)
______
A)
Erythema
B)
Cyanosis
C)
Jaundice
D)
Pallor
33)
A client with thick wavy hair comes into the clinic. The nurse realizes that this client's hair is indicative of:
33)
______
A)
Hormone deficiency.
B)
Adequate nutrition.
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C)
Vitamin deficiency.
D)
Poor nutrition.
34)
A client is waiting to have a skin biopsy and asks, "What is going to happen when this is done?" Which of the following
would be an appropriate response for the nurse to make?
34)
______
A)
"I'm not sure."
B)
"Let me check to see exactly what you are having done and then we can talk more about what you can expect."
C)
"Maybe you shouldn't have it done."
D)
"Didn't your doctor tell you?"
35)
The nurse is conducting a focused interview about a client's integumentary status. Which of the following client
characteristics would cause the nurse to focus on risk factors for skin cancer?
35)
______
A)
Blond hair and blue eyes
B)
Is a child daycare worker
C)
Female, age 35
D)
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Home in Portland, Maine
36)
The nurse is preparing to assess a client's integumentary status. Which of the following techniques should the nurse use to
conduct this assessment?
36)
______
A)
Inspection and percussion
B)
Inspection
C)
Percussion and palpation
D)
Inspection and palpation
37)
The nurse is planning to assess an African-American's integumentary status. Which of the following findings would indicate
the presence of cyanosis in this client?
37)
______
A)
Orange-green cast to the skin
B)
Bluish-tinged nail beds
C)
Yellow hue in the eyes
D)
Cherry-red lips
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38)
A client with a history of pruritis says, "The itching seems to improve when I take my allergy medicine." The nurse realizes
that this is most likely because:
38)
______
A)
The allergy medication is reducing histamine release.
B)
The client's pruritis is improving.
C)
The client is distracted from the itching because of the allergies.
D)
The client is taking other medication of which the nurse is not aware.
39)
The nurse instructs a client with melanoma to "eat foods rich in protein and calories". This intervention is most likely
associated with which of the following nursing diagnosis?
39)
______
A)
Hopelessness
B)
Fluid Volume Deficit
C)
Anxiety
D)
Impaired Skin Integrity
40)
A client confined to bed has slid to the bottom of the bed. Which of the following should the nurse do to adjust this client's
body position?
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40)
______
A)
Pull the client up in bed.
B)
Slide the client up in bed.
C)
Do nothing.
D)
Lift the client up in bed.
41)
A client in a wheelchair has a history of sacral pressure ulcer formation. Which of the following instructions should be
included in the client's teaching?
41)
______
A)
Shift the weight every 15 minutes to one hour.
B)
Have a family pull the client up in the wheelchair.
C)
Sit on a donut.
D)
Stay in one position as long as possible.
42)
A client says, "I'm glad I only have diabetes. Many of my friends have heart problems." Which of the following would be an
appropriate response for the nurse to make to this client?
42)
______
A)
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"You are lucky."
B)
"Diabetes can affect your heart if it is not controlled."
C)
"I bet your friends have diabetes too."
D)
"I agree."
43)
A client tells the nurse, "I eat all the time but I'm losing weight and I can't stop going to the bathroom!" The nurse realizes that
this client is describing:
43)
______
A)
Neuropathy.
B)
Retinopathy and polyphagia.
C)
Polyphagia and polydipsia.
D)
Polyphagia and polyuria.
44)
An elderly client with type 2 diabetes says, "I don't want to be on the needle for the rest of my life." Which of the following
would be an appropriate response for the nurse to make to this client?
44)
______
A)
"You need it for now. There's a chance you won't need it after you get well."
B)
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"I'll teach you how to give yourself insulin."
C)
"The needle barely hurts."
D)
"You can always refuse to take it."
45)
A client is scheduled for an oral glucose tolerance test. Which of the following medications should the client be instructed to
stop for three days before the test?
45)
______
A)
Heart-regulating medication
B)
Warfarin (Coumadin)
C)
Multiple vitamin
D)
Blood pressure medication
46)
A client with type 2 diabetes says, "I was feeling really shaky yesterday so I drank a few ounces of orange juice and felt
better." Which of the following should the nurse instruct this client?
46)
______
A)
Nothing. This is an appropriate intervention for the client to make.
B)
"Call the doctor if this happens again."
C)
"If this happens again, check your blood glucose level with your monitor."
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D)
"Go to the emergency room if this happens again."
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question.
47)
The nurse is preparing to mix 20 units of NPH insulin with 8 units of regular insulin into one syringe for injection. Select the
order of the steps the nurse should follow:
1. Wipe tops of both vials with alcohol.
2. Inject 8 units of air into the regular insulin vial.
3. Inject 20 units of air into the NPH insulin vial.
4. Withdraw 20 units of NPH insulin into the syringe.
5. Withdraw 8 units of regular insulin into the syringe.
47)
_____________
MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.
48)
A client with diabetes says, "I am watching everything that I eat and only buy sugar-free sodas but I still can't lose any
weight!" Which of the following could the nurse say to this client?
48)
______
A)
"How much water are you drinking everyday?"
B)
"Everyone cheats every now and then."
C)
"Sugar-free doesn't mean no calories."
D)
"Are you sure you are only buying sugar-free items?"
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49)
A client with type 2 diabetes wants to lose 20 lbs and asks the nurse to help plan her meal pattern. Which of the following
would be appropriate for this client to aid with weight loss and blood glucose level maintenance?
49)
______
A)
Plan for a small breakfast and dinner with a large lunch and a bedtime snack.
B)
Plan for a small breakfast, moderate-sized lunch, and large dinner with a bedtime snack.
C)
Eat the largest meal of the day for breakfast and two small meals for lunch and dinner.
D)
Plan for three equal-sized meals with one or two snacks.
50)
A postoperative client with type 2 diabetes says, "I was under better control before the operation. Now I'm on insulin." Which
of the following could the nurse say to this client?
50)
______
A)
"Didn't your doctor tell you that you would be on insulin now?"
B)
"Giving injections is easy."
C)
"It happens."
D)
"It's just until you are able to take your other medication and start to recover from the surgery."
51)
A client with type 1 diabetes comes into the emergency department with deep respirations, lethargy, and extreme thirst. The
nurse realizes that this client is demonstrating:
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51)
______
A)
Possible diabetic ketoacidosis (DKA).
B)
Insulin overdose.
C)
Hypoglycemia.
D)
The onset of the flu.
52)
A client with type 2 diabetes asks, "What can I do to prevent heart problems?" Which of the following can the client do to
avoid this long term complication?
52)
______
A)
Avoid high-sugar-content fruits.
B)
Limit exercise to two times per week.
C)
Stop smoking.
D)
Restrict fluids.
53)
A client with diabetes says, "I think I have a back problem. My feet are getting numb." The nurse realizes that this client could
be describing:
53)
______
A)
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Visceral neuropathy.
B)
Gastroparesis.
C)
Polyneuropathy.
D)
Mononeuropathy.
54)
The nurse determines that a client has evidence of peripheral vascular disease associated with diabetes. Which of the
following findings did the nurse most likely assess?
54)
______
A)
Dusky skin tone
B)
Skin between toes intact
C)
Even hair distribution on legs
D)
Feet warm and dry bilaterally
55)
A client with diabetes says, "I want to check my feet everyday but I can't lift my legs because of arthritis in my knees." Which
of the following techniques could the nurse instruct this client?
55)
______
A)
"Only wear soft shoes and slippers."
B)
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"Don't worry about it unless pain in the feet is present."
C)
"Prop a mirror against the wall and lift the foot, checking for any skin breakdown."
D)
"Check the inside of socks when changing for any bleeding."
56)
During a visit, the home care nurse finds a safety hazard in the home of a client with diabetes. Which of the following did the
nurse assess in this client's home?
56)
______
A)
Throw rugs in the kitchen and bathroom
B)
Shower chair
C)
Grab bars next to the commode
D)
Night lights
57)
A client with diabetes tells the nurse, "I plan to lose 30 lbs. in two months." The nurse realizes that this client:
57)
______
A)
Is highly motivated.
B)
Needs bariatric surgery.
C)
Has set a goal that is achievable.
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D)
Is not being realistic with the goal.
58)
A married female client has a history of repeated urinary tract infections (UTIs). Which of the following should the nurse
include while assessing this client?
58)
______
A)
Activity status
B)
Preferred method of birth control
C)
Height and weight
D)
Employment status
59)
Which one of the following methods of bladder emptying would be preferred for an elderly client who is prone to developing
urinary tract infections (UTIs)?
59)
______
A)
Indwelling urinary catheterization
B)
Crede maneuver
C)
Timed intervals for taking client to bathroom to void
D)
Intermittent catheterization
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60)
A client is diagnosed with chronic pyelonephritis. The nurse realizes that this client is prone to developing:
60)
______
A)
Cystitis.
B)
Renal calculi.
C)
Acute renal failure.
D)
Chronic renal failure.
61)
A client with an indwelling urinary catheter is demonstrating signs of asymptomatic bacteriuria. Which of the following
would be the best course of action for this client?
61)
______
A)
Begin oral antibiotic therapy for three days.
B)
Begin intravenous antibiotic therapy.
C)
Remove the catheter and monitor for continued signs of bacteriuria.
D)
Remove the catheter and begin antibiotic therapy.
62)
A client asks the nurse for ways to prevent recurrent urinary tract infections. Which of the following is an appropriate nursing
response?
62)
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______
A)
"Clean the perineal area from back to front."
B)
"Use feminine hygiene sprays."
C)
"Wear clean nylon underpants."
D)
"Avoid douching."
63)
A male client comes into the emergency department with symptoms of renal colic. The nurse realizes that this client most
likely has a calculi that is obstructing the:
63)
______
A)
Ureter.
B)
Bladder.
C)
Renal pelvis.
D)
Urethra.
64)
A male client has a history of calcium calculi. Which of the following medications can be prescribed to help this client?
64)
______
A)
NSAIDs
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B)
Allopurinol (Alloprim)
C)
Penicillin (Pentids)
D)
Furosemide (Lasix)
65)
A client had a renal stent removed. Which of the following should be included in the care of this client?
65)
______
A)
Monitor blood pressure.
B)
Encourage ambulation.
C)
Monitor urine output.
D)
Ensure an adequate protein intake.
66)
A male client with a urinary stoma says, "I looked at it while you were out of the room. It's not so bad." The nurse realizes that
this client is demonstrating:
66)
______
A)
Denial.
B)
Grief.
C)
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Anger.
D)
Coping.
67)
A female client is admitted with an overdistended bladder. Which of the following diagnostic tests can be done to confirm the
diagnosis of urine retention?
67)
______
A)
Bladder scan
B)
MRI
C)
Intravenous pyelography (IVP)
D)
Renal scan
68)
While being catheterized for urinary retention, the client becomes diaphoretic and pale. Which of the following can be done to
help this client?
68)
______
A)
Nothing. This is a normal response.
B)
Pull the urinary catheter.
C)
Clamp the catheter after draining 500 cc of urine.
D)
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Provide the client with fluids.
69)
A female client is admitted with multiple medical problems and incontinence, regardless of the position or situation. The type
of incontinence that this client is most likely experiencing is:
69)
______
A)
Stress.
B)
Overflow.
C)
Urge.
D)
Total.
70)
An 80-year-old female client says to the nurse, "I can't hold my water very well so I don't leave the house much." Which of
the following is an appropriate nursing response?
70)
______
A)
"I guess it's hard getting older."
B)
"This is not something you have to live with. Talk with your doctor about this problem."
C)
"Do you get enjoyment out of watching television?"
D)
"I understand."
71)
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A male client needs to increase the acidity of his urine. Which foods should this client increase in his diet?
71)
______
A)
Green vegetables and oranges
B)
Sardines and herring
C)
Cranberries, grapes, and tomatoes
D)
Beans, chocolate, and dairy products
72)
A client who is recovering from spinal surgery had "an accident" while attempting to reach the bathroom to void. The type of
incontinence this client most likely experienced is:
72)
______
A)
Total.
B)
Urge.
C)
Functional.
D)
Stress.
73)
An older female adult client is seen in the clinic and is surprised to find that she is shorter than she was a few years ago. The
client thinks the nurse may have made a mistake. What is the best response by the nurse?
73)
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______
A)
Teach the client that older adults often lose height based on poor posture, bone compression fractures, and their sedentary
lifestyles.
B)
Teach the client that osteoporosis and age-related loss of bone mass could be responsible for a decrease in height and that it
would be good to talk with the physician about this.
C)
Teach the client that old people are not active enough so eventually they have a decrease in their bone mass that they could
have prevented.
D)
Tell the client that she is wrong, and that nurses see this happen every day in old people.
74)
The nurse expects to care for clients most often with which of the following types of arthritis?
74)
______
A)
Osteoarthritis
B)
Rheumatoid arthritis
C)
Ankylosing spondylitis
D)
Gouty arthritis
75)
One of the first symptoms of osteoarthritis the nurse expects to note in the assessment is:
75)
______
A)
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Pain when at rest.
B)
Crepitus in the joint with movement.
C)
Inability to walk long distances due to fatigue.
D)
Pain and stiffness in one or more joints.
76)
A client has early onset osteoarthritis of the left knee. The nurse expects which medication will be ordered?
76)
______
A)
Prednisone
B)
Meperidine (Demerol)
C)
Hyaluronan (Synvisc)
D)
Ibuprofen (Motrin)
77)
The nurse is having a conversation with an older adult with Parkinson's disease. Which of the following would this client
most likely exhibit during conversation with the nurse?
77)
______
A)
Angry, loud talk
B)
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Jumbled words that do not make sense
C)
Bubbly, spirited discussion
D)
A low-pitched monotone voice
78)
A client who was diagnosed with Parkinson's disease is demonstrating bradykinesia. The nurse will likely observe the
following actions in this client:
78)
______
A)
Active exercise and high energy as required to perform activities of daily living.
B)
A loss of spontaneous movement.
C)
An increase in spontaneous movements that occur more slowly.
D)
Very slow talk.
79)
Medication does not stop all symptoms with Parkinson's disease. The nurse notes tremors and muscle rigidity in an older adult
client. Expected medication to combat these symptoms includes: (Select all that apply.)
79)
______
A)
Acetaminophen (Tylenol).
B)
Meperidine (Demerol).
C)
Propranolol (Inderal).
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D)
Nitroglycerin (Nitrobid).
80)
An adult client has been diagnosed with Bell's palsy. The client asks if the facial paralysis and distortion will go away. The
nurse should answer:
80)
______
A)
"Most people have permanent facial paralysis on one side of the face."
B)
"Everyone recovers from Bell's palsy in three to five weeks."
C)
"About 80% of people recover completely within a few weeks to a few months, but there can be lasting effects."
D)
"Most people have permanent facial paralysis on both sides of the face."
81)
Huntington's disease has no cure and causes progressive chorea, speech problems, and dementia. When teaching the newly-
diagnosed client about the disease, the client asks the nurse whether it can be passed on to future children. The nurse's best
response is:
81)
______
A)
"The disease is passed on genetically in 75% of offspring."
B)
"There may be genetic concerns that should be discussed with the physician."
C)
"Each child will have a 50% chance of inheriting the gene."
D)
"Children will not be affected by the disease."
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82)
The nurse is caring for a client with amyotrophic lateral sclerosis (ALS). The nurse realizes that the prognosis is:
82)
______
A)
Poor. The disease rapidly progresses and is fatal.
B)
Excellent. The disease will progress slowly and can be controlled by medication.
C)
Good. The disease progresses rapidly but can be halted by drug therapy.
D)
Good. The disease will progress over many years but the quality of life will be good.
83)
Once amyotrophic lateral sclerosis (ALS) is diagnosed, the priority nursing activity is to:
83)
______
A)
Assist the client to adapt to the disease.
B)
Monitor for infection.
C)
Support the client and family to meet physical and psychosocial needs.
D)
Assist the client to avoid complications.
84)
The nurse understands that tetanus is completely preventable by:
84)
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______
A)
Debriding the bite wound.
B)
Administering antibiotics immediately after a bite.
C)
Passive immunization.
D)
Active immunization.
85)
A 30-year-old nurse who works on a busy medical-surgical unit has been diagnosed with multiple sclerosis (MS). The priority
for this client is to:
85)
______
A)
Continue to work as scheduled without making changes.
B)
Leave employment as a nurse due to the need for complete bed rest.
C)
Negotiate a regular schedule of working 8-hour dayshifts and consider applying for nursing positions that are less stressful
and demanding.
D)
Work as hard as possible now because later, it may not be possible.
86)
A client who became blind in his left eye because of an industrial accident says, "I still have one good eye and I can still do a
lot." The nurse realizes that this client is demonstrating signs of:
86)
______
A)
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Acceptance.
B)
Denial.
C)
Anticipatory grieving.
D)
Remorse.
87)
The nurse is instructing a client on the self-instillation of eye drops for acute conjunctivitis. The most important step to
instruct this client is:
87)
______
A)
Proper handwashing before instilling the drops.
B)
Insert contact lenses after the eye drops have been instilled.
C)
Rub the eyes only when necessary.
D)
Reuse cotton swabs as needed.
88)
A teenage client is diagnosed with a corneal abrasion. Which of the following should the nurse instruct this client?
88)
______
A)
Gently rub the eyes when itchy.
B)
Use the prescribed eye drops until the symptoms disappear.
40 of 53 3/1/11 8:25 AM
C)
Do not share or use another person's eye makeup.
D)
Only share a towel with family members.
89)
An elderly client with a mobility disorder is being discharged after having a cataract removed as an outpatient. The nurse
should assess this client for their:
89)
______
A)
Ability to drive.
B)
Ability to ambulate.
C)
Ability to read discharge instructions.
D)
Ability to provide eye drops postprocedure.
90)
The nurse assesses a reduction in a client's peripheral vision. Which of the following additional measures is a priority during
the assessment of this client?
90)
______
A)
Neck range of motion assessment
B)
Cranial nerve assessment
C)
Retina assessment
D)
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Intraocular pressure assessment
91)
A client with COPD is being treated for glaucoma. The medication that will most likely be prescribed for this client is a(an):
91)
______
A)
Calcium channel blocker
B)
Beta—blocker.
C)
Antibiotic.
D)
Adrenergic agonist.
92)
The client's right femur was fractured and repaired at the diaphysis. When teaching, the client asks the nurse to explain the
diaphysis. The nurse's best response is:
92)
______
A)
"Long bones like the femur have a midportion or shaft that is also called the diaphysis."
B)
"Short bones like the femur are cuboid, spongy bone that, in medical terms, are called the diaphysis."
C)
"Flat bones like the femur are disc-shaped and, in medical terms, are called the diaphysis."
D)
"Irregular bones like the femur are plates of compact bone that are also called the diaphysis."
93)
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The client is ordered to be on bed rest for two months. The nurse realizes that the client's bones will:
93)
______
A)
Increase their osteoblastic activity to promote ossification.
B)
Undergo increased osteoclast activity and bone resorption.
C)
Be affected positively by the rest and be stronger as a result.
D)
Not be affected by the bed rest.
94)
The client is recovering from orthopedic surgery on a fractured arm. The nurse realizes that for musculoskeletal function,
what type of muscle is needed?
94)
______
A)
Skeletal
B)
A combination of skeletal and smooth
C)
Smooth
D)
Cardiac
95)
The nurse is teaching about an endoscopic examination of the interior surfaces of a joint during which surgery and diagnosis
can also be accomplished. What is a correct name for this technique?
95)
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______
A)
Arthrogenesis
B)
Arthrodonesia
C)
Arthrocentesis
D)
Arthroscopy
96)
The client is about to have a magnetic resonance imaging (MRI) to diagnose a soft tissue abnormality of the lower leg. The
nurse should immediately notify the physician about which of the following?
96)
______
A)
The client did not eat breakfast due to earlier nausea.
B)
The client has a history of hypertension.
C)
The client has a concern about what will be found on the MRI.
D)
The client has a pacemaker.
97)
When caring for older adults, the nurse realizes that an age-related change in the musculoskeletal system is:
97)
______
A)
Difficulty with dexterity after age 50.
44 of 53 3/1/11 8:25 AM
B)
Decreased bone mass and calcium absorption, which lead to a chance for fractures.
C)
Vertebrae lengthen and thin, which leads to increased bone production.
D)
Pain when ambulating due to increased bone mass and minerals.
98)
A young adult is seen in the clinic complaining of pain in the left wrist. There is no deformity of the wrist, the left radial pulse
is strong, and there is no history of a fall or injury. What does the nurse expect to see ordered?
98)
______
A)
A computerized tomography (CT) scan of the wrist to check for soft tissue injury
B)
An x-ray of both arms to ensure there is no injury present
C)
Lab work to assess calcium and phosphorus levels
D)
Rest and comfort measures for several days unless pain worsens
99)
A client's gait is considered normal during assessment if:
99)
______
A)
The gait is slow and deliberate as if the client is gingerly pulling one side up to meet the other.
B)
The client does not stumble, run into objects, or fall.
C)
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The gait is jerky and quick, which indicates the client has excellent motor control.
D)
The gait is smooth and steady without limping.
100)
The nurse is assessing the client's spine, and the assessment includes an abnormal finding. The nurse should conduct further
assessment by asking the client to:
100)
_____
A)
Stand, bend back slowly, then to the right and left while the nurse looks from the back.
B)
Lie down on their abdomen so the nurse can look at the back more carefully.
C)
Bend over, stand tall, and stretch arms over the head.
D)
Sit and then stand as the nurse observes the client from the front.
1)
2)
B, C, D
3)
4)
5)
6)
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7)
8)
9)
10)
11)
12)
13)
14)
15)
16)
17)
18)
19)
20)
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21)
22)
23)
24)
25)
26)
27)
28)
29)
30)
31)
32)
33)
34)
35)
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36)
37)
38)
39)
40)
41)
42)
43)
44)
45)
46)
47)
1, 3, 2, 5, 4
48)
49)
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50)
51)
52)
53)
54)
55)
56)
57)
58)
59)
60)
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62)
63)
64)
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65)
66)
67)
68)
69)
70)
71)
72)
73)
74)
75)
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77)
78)
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53 of 53 3/1/11 8:25 AM

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midterm practice 2011.rtf https://mail.google.com/mail/?ui=2&ik=905dc2694f&view=att...

Use primary nursing to deliver care.

Work in interdisciplinary teams.

Replace quality improvement initiatives with work redesign methods.

Use informatics to deliver care.

Use evidence-based practice.

The client wants attention.

The client's pain is real.

The client is demanding.

The client just wants medication.

"You must have an autoimmune disorder."

"The organism found you more susceptible to the creation of an infection."

Monitor blood glucose level every eight hours.

Administer one-half of the prescribed insulin dose.

Administer insulin dose as prescribed.

Limit rest to only eight hours per day.

Finding out the client's allergies.

Initiating a peripheral IV in the opposite arm.

Cleansing the arm with antibacterial cleanser.

Doing no special preparation.

Give the charge nurse a report.

Reassess the client.

Responsible to re-measure all of the vital signs.

Not accountable for these vital signs.

Not responsible for these vital signs.

Accountable for the care that was delegated.

"Wellness is a passive state of freedom from illness."

"Good health maximizes individual potential."

"There isn't a difference."

"Wellness maximizes individual potential."

Perform foot self-examinations daily.

Perform breast self—examinations.

Have a tetanus booster every ten years.

Sign them up to learn CPR.

Ask the client the reasons for concern.

Urinary tract infection

"Are you sleeping at least seven hours per night?"

"Are you drinking enough fluids?"

A belief in alternative methods

One reason to reduce the amount of pain medication prescribed.

The body's ability to make endorphins.

Adult attention deficit disorder.

High pain tolerance.

Evaluation by a psychiatrist to determine if the client is really depressed

Develop a pain medication schedule to help avoid the onset of pain.

Avoid the use of narcotics.

A thorough analysis of the pain to determine if it is truly pain

A nonsteroidal anti-inflammatory drug (NSAID).

Provide the medication ordered for breakthrough pain.

Talk the client through the pain.

Give the client a nonsteroidal anti-inflammatory drug (NSAID).

Encourage the client to ignore the pain.

The client will never overdose with this delivery method.

Dosing will start with a lower dose.

It will not work as well as oral pain medications.

The client will never experience breakthrough pain.

Psychological evaluation tool

The desire for narcotics.

Inconsistent behavioral response to pain.

"I'm not sure."

"Maybe you shouldn't have it done."

"Didn't your doctor tell you?"